结核性胸膜炎的临床特征(附345例分析)

目的　进一步了解结核性胸膜炎的临床特点及其与肺结核的关系。方法 对345例结核性胸膜炎病人的临床特征进行回顾性分析。结果 ①年龄分布,<35岁占51.6%,≥55岁占23.2%,平均38.1岁。②发热、咳嗽、胸痛的发生率分别为73.6%、57.7%和51.9%。③单侧胸水占93.0%,双侧胸水占7.0%,左、右侧发生率分别为47.8%及45.2%。④中、小量胸水共占94.5%,大量胸水仅占5.5%。⑤胸膜炎同时合并肺结核占47.8%。⑥胸水呈草黄色占89.6%,呈血性占10.4%。⑦胸水结核菌检出率为3.2%。⑧PPD试验阳性反应者占83.3%。⑨红细胞沉降率(ESR)增快者占64.9%,均值为46.9mm/1h。结论 结核性胸膜炎仍是目前的常见疾病之一,多见于青少年,与肺结核关系密切,在诊断时应注意其临床特点。

The clinical analysis of 345 patients with tuberculous pleurisy

Objective To further investigate the clinical character of tuberculous pleurisy (TP) and the relationship between tuberculous pleurisy and pulmonary tuberculosis.Methods The clinical status of 345 patients with tuberculous pleurisy were retrospectively analyzed.Results ①The age distribution in 345 patients was 51.6% for patients below 35,23.2% over 55. The average age of the overall patients was 38.1. ②Occurrence rate for fever, cough, chest pain was 73.6%, 57.7% and 51.9% respectively. ③Occurence rate for unilateral pleural effusion, bilateral pleural effusion, left and right lateral pleural effusion was 93.0%, 7.0%, 47.8% and 45.2% respectively. ④Moderate and mild pleural effusion was 94.5%, severe pleural effusion was only 5.5%. ⑤The patients with pleurisy occupied 16% for the overall. The patients of tuberculous pleurisy complicated with pulmonary tuberculosis were 47.8%. ⑥The patients with yellow pleural effusion was 89.6%. With bleeding pleural effusion was 10.4%. ⑦The positive rate of M.tuberculosis was 3.2% and 16.8% in pleural effusion and sputum. ⑧The positive rate in PPD reaction was 83.3%. ⑨The increasing ESR was 64.9%, and its mean value was 46.9mm/1h. Conclusion The tuberculous pleurisy was more often occurred in young people. It has close relationship with pulmonary tuberculosis. It is necessary to consider its clinical character in diagnosis.